Avery's neonatology : pathophysiology & management of the - download pdf or read online

By Gordon B Avery; Mhairi G MacDonald; Mary M K Seshia; Martha D Mullett

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They demonstrate the best survival rates for small premature and other categories of infants at highest risk, and they provide the standard by which perinatal care is judged. The natural alliance between perinatal obstetrics and neonatology is so great that some have suggested it receive department status within the medical complex. In some ways, the perinatal center accomplishes this on an ad hoc basis. However, perinatologists and neonatologists are parts of traditional departments of obstetrics and pediatrics, with surgical and medical orientations, respectively.

Gordon B. D. Table of Contents Part I - General Considerations Chapter 1 - Neonatology: Past, Present and Future • PAST: THE ROOTS • PRESENT: THE TRUNK • THE BRANCHES • THE PRESENT • THE FUTURE • REFERENCES Chapter 2 - Current Moral Priorities and Decision Making in Neonatal-Perinatal Medicine • GOALS OF NEONATAL-PERINATAL MEDICINE • SOCIETAL AND PROFESSIONAL ISSUES • ETHICS AND MORAL DELIBERATION • CULTURAL AND RELIGIOUS DIVERSITY • HIV SCREENING OF PREGNANT WOMEN AND NEWBORN INFANTS • SUBSTANCE ABUSE IN PREGNANCY • GENETIC TESTING • MAKING DECISIONS REGARDING THE APPROPRIATENESS OF INTERINSTITUTIONAL TRANSFER • REFERENCES Chapter 3 - Neonatology in the United States: Scope and Organization • THE CAPACITY TO DELIVER IN-HOSPITAL NEONATAL CARE • COSTS OF DELIVERING NEONATAL CARE • MAJOR MEASURES OF OUTCOME • MAJOR MORBIDITIES • REGIONALIZATION TODAY • REFERENCES Chapter 4 - Neonatal Transport • HISTORY • ORGANIZATION AND ADMINISTRATION • TECHNICAL ASPECTS • DOCUMENTATION • QUALITY ASSURANCE • PSYCHOSOCIAL CONSIDERATIONS • LEGAL CONSIDERATIONS • BACK TRANSPORT • REFERENCES Chapter 5 - Telehealth in Neonatology • THE HISTORY OF TELEHEALTH • TECHNOLOGY • MEDICO-LEGAL AND REGULATORY ISSUES • THE ECONOMICS AND EVALUATION OF TELEHEALTH • TELEHEALTH APPLICATIONS IN NEONATOLOGY • PRACTICAL STEPS IN GETTING STARTED • IMPLICATIONS FOR THE FUTURE • REFERENCES Chapter 6 - Newborn Intensive Care Unit Design: Scientific and Practical Considerations • DEVELOPING A MISSION STATEMENT • CREATING THE TEAMS • SITE VISITS • SPECIFIC DESIGN ISSUES • EQUIPMENT SELECTION • REVIEW AND APPROVAL PROCESS • HUMAN DYNAMICS CRUCIAL TO A SUCCESSFUL MOVE • CHANGE-IN-PLACE • REFERENCES Chapter 7 - Organization of Care and Quality in the NICU • ORGANIZATION OF CARE • QUALITY IN THE NEONATAL INTENSIVE CARE UNIT • CONCLUSION • REFERENCES Chapter 8 - Law, Quality Assurance and Risk Management in the Practice of Neonatology • BASIC LEGAL AND REGULATORY CONCEPTS • QUALITY ASSURANCE, PERFORMANCE IMPROVEMENT, ANDRISK MANAGEMENT • CONCLUSIONS • REFERENCES Chapter 9 - The Vulnerable Neonate and the Neonatal Intensive Care Environment • NEONATAL SENSORY SYSTEMS: DEVELOPMENT, DISORDERS, ENVIRONMENT, AND INTERVENTION • GENERAL PRINCIPLES • ACKNOWLEDGMENTS • REFERENCES Part II - The Fetal Patient Chapter 10 - Prenatal Diagnosis in the Molecular Age— Indications, Procedures, and Laboratory Techniques • GENE ORGANIZATION • ELEMENTS OF MOLECULAR GENETICS • PRENATAL DIAGNOSIS • REFERENCES Chapter 11 - Feto-Maternal Interactions: Placental Physiology, the In Utero Environment, and Fetal Determinants of Adult Disease • HUMAN PLACENTATION • PLACENTAL TRANSFER • PLACENTAL METABOLISM • PLACENTA AS AN ENDOCRINE ORGAN • AMNIOTIC FLUID • FETAL MEMBRANES • UMBILICAL CORD • PLACENTAL PHYSIOLOGY IN DISEASE STATES • THE IN UTERO ENVIRONMENT AND FETAL DETERMINANTS OF ADULT DISEASE • BIRTH-WEIGHT AND CORONARY HEART DISEASE • BIRTH-WEIGHT AND HYPERTENSION • BIRTH-WEIGHT AND DIABETES • REFERENCES Chapter 12 - Fetal Imaging: Ultrasound and Magnetic Resonance Imaging • ASSESSMENT OF FETAL AGE, GROWTH, AND MATURITY • DETERMINING FETAL AGE • FETAL WEIGHT ESTIMATES • ASSESSMENT OF FETAL GROWTH • FETAL ANATOMY • DETECTION OF FETAL ASPHYXIA • DOPPLER ASSESSMENT OF BLOOD VELOCITIES IN UMBILICAL AND FETAL VESSELS • SUMMARY • REFERENCES Chapter 13 - Fetal Therapy • SURGICAL THERAPY • ENDOCRINE DISORDERS • INBORN ERRORS OF METABOLISM • PRENATAL HEMATOPOIETIC STEM CELL TRANSPLANTATION • CONCLUSION • References Chapter 14 - The Impact of Maternal Illness on the Neonate • PRETERM DELIVERY • MATERNAL NUTRITION • MATERNAL ILLNESSES • SUMMARY • REFERENCES Chapter 15 - The Effects of Maternal Drugs on the Developing Fetus • CHARACTERIZATION OF ADVERSE REPRODUCTIVE OUTCOMES • FACTORS THAT AFFECT SUSCEPTIBILITY TO THE DELETERIOUS EFFECTS OF DRUGS • ACKNOWLEDGMENTS • REFERENCES Chapter 16 - Obstetric Anesthesia and Analgesia: Effects on the Fetus and Newborn • EVALUATION OF WELL-BEING • PAIN MANAGEMENT • ANALGESIC TECHNIQUES FOR LABOR: EFFECTS ON THE FETUS AND NEWBORN • SURGERY DURING PREGNANCY • RESUSCITATION ISSUES DURING PREGNANCY • ANESTHETIC TECHNIQUES FOR CESAREAN SECTION: EFFECTS ON THE FETUS AND NEWBORN • POSTPARTUM PAIN MANAGEMENT • CONCLUSION • ACKNOWLEDGEMENT • REFERENCES Part III - Transition and Stabilization Chapter 17 - Cardiorespiratory Adjustments at Birth • PULMONARY ADAPTATION • RESPIRATORY ADAPTATION • CIRCULATORY ADAPTATION • CONCLUSION • REFERENCES Chapter 18 - Delivery Room Management • RESPIRATORY ADAPTATION • CIRCULATORY ADAPTATION • PATHOPHYSIOLOGY OF INTRAPARTUM ASPHYXIA AND RESUSCITATION • HIGH-RISK PREGNANCIES • RESUSCITATION OF THE ASPHYXIATED INFANT • DISCONTINUATION OF RESUSCITATION • SPECIAL PROBLEMS • ACKNOWLEDGMENTS • REFERENCES Chapter 19 - Physical Assessment and Classification • NEWBORN HISTORY • GESTATIONAL AGE ASSESSMENT • GROWTH • EXAMINATION • REFERENCES Chapter 20 - General Care • ANTENATAL • INTRAPARTUM • NEONATAL • SPECIFIC CONGENITAL INFECTIONS • POST-DISCHARGE • REFERENCES Chapter 21 - Fluid and Electrolyte Management • BODY COMPOSITION OF THE FETUS AND NEWBORN INFANT • INSENSIBLE WATER LOSS • NEUROENDOCRINE CONTROL OF FLUID AND ELECTROLYTE BALANCE • RENAL FUNCTION IN RELATION TO FLUID AND ELECTROLYTE THERAPY • PRINCIPLES OF FLUID AND ELECTROLYTE THERAPY • ACID-BASE BALANCE • FLUID AND ELECTROLYTE PROBLEMS ASSOCIATED WITH SPECIFIC CLINICAL CONDITIONS • TECHNICAL ASPECTS OF PARENTERAL FLUID THERAPY • REFERENCES Chapter 22 - Nutrition • NUTRITIONAL CAPABILITIES OF THE NEWBORN INFANT • NUTRIENT REQUIREMENTS FOR TERM AND PRETERM INFANTS • NUTRIENT DELIVERY • WHAT TO FEED NEWBORN INFANTS • NUTRITIONAL MONITORING • REFERENCES Chapter 23 - Breastfeeding and the Use of Human Milk in the Neonatal Intensive Care Unit • OVERVIEW • BACKGROUND • INCIDENCE OF BREASTFEEDING OR PROVISION OF HUMAN MILK • ADVANTAGES OF HUMAN MILK FOR PREMATURE AND COMPROMISED BABIES • CHALLENGES TO THE PROVISION OF HUMAN MILK • THE USE OF MOTHER'S MILK IN NEONATAL INTENSIVE CARE • FORTIFICATION OF HUMAN MILK FORVERY LOW BIRTH WEIGHT BABIES • THE DEVELOPMENTAL PROGRESSION TOWARD BREASTFEEDING • ONGOING BREASTFEEDING SESSIONS • DISCHARGE PLANNING • SUPPORTING BREASTFEEDING IN THE NEONATAL INTENSIVE CARE UNIT AND AFTER DISCHARGE • SPECIAL CIRCUMSTANCES • CONTRAINDICATIONS TO BREAST FEEDING • MEDICATIONS AND DRUGS • CONCLUSION • REFERENCES Chapter 24 - Thermal Regulation • A HISTORICAL PERSPECTIVE • THERMAL BALANCE AT THE BEGINNING OF LIFE • CONVECTION-WARMED INCUBATORS • THE RADIANT WARMER BED • HEAT SHIELDING • EPIDERMAL BARRIER PROTECTION • HYBRID INCUBATOR/RADIANT WARMER DESIGN • FEVER • PHYSIOLOGIC CONTROL OF BODY TEMPERATURE • MECHANISMS PRODUCING NEONATAL FEVER • REFERENCES Part IV - The Low-Birth-Weight Infant Chapter 25 - The Extremely Low-Birth-Weight Infant • EPIDEMIOLOGY • PERINATAL MANAGEMENT • FLUIDS AND ELECTROLYTES • MAJOR MORBIDITIES OF THE EXTREMELY LOW-BIRTH-WEIGHT INFANT • FOLLOW-UP OF THE EXTREMELY LOW BIRTH WEIGHT INFANT • FUTURE DIRECTIONS AND ETHICAL ISSUES • ACKNOWLEDGMENTS • REFERENCES Chapter 26 - Intrauterine Growth Restriction and the Small-For-GestationalAge Infant • INTRODUCTION • DEFINITIONS • INTERPRETATION OF FETAL GROWTH CURVES • INTRAUTERINE GROWTH RESTRICTION AND PRETERM BIRTH • FETAL GROWTH • GROWTH OF BODY COMPONENTS IN THE FETUS • REGULATION OF FETAL GROWTH • FETAL NUTRIENT UPTAKE AND METABOLISM AND REGULATION OF FETAL GROWTH • ANTENATAL CARE OF THE INTRAUTERINE GROWTH-RESTRICTED FETUS • CLINICAL EVALUATION AND TREATMENT OF THE SMALL-FOR-GESTATIONAL AGE INFANT • CLINICAL PROBLEMS OF THE SMALL-FOR-GESTATIONAL-AGE NEONATE ( • OUTCOMES AND LONG-TERM CONSEQUENCES OF SMALL-FOR-GESTATIONALAGE INFANTS • REFERENCES Chapter 27 - Multiple Gestations • EPIDEMIOLOGY • IMPACT OF REPRODUCTIVE TECHNOLOGY • ZYGOSITY • PLACENTATION • ANTEPARTUM COMPLICATIONS • ANTENATAL MANAGEMENT • LABOR AND DELIVERY • MORTALITY • TWIN-TO-TWIN TRANSFUSION SYNDROME • STUCK TWIN • ASPHYXIA • GROWTH • CONGENITAL ANOMALIES • NEONATAL DISORDERS • POSTNEONATAL CARE AND FOLLOW-UP • REFERENCES Part V - The Newborn Infant Chapter 28 - Control of Breathing: Development, Apnea of Prematurity, Apparent Life-Threatening Events, Sudden Infant Death Syndrome • NORMAL CONTROL OF BREATHING • CLINICAL DISORDERS IN CONTROL OF BREATHING • IDIOPATHIC APPARENT LIFE-THREATENING EVENTS • SUDDEN INFANT DEATH SYNDROME • REFERENCES Chapter 29 - Acute Respiratory Disorders • HUMAN LUNG DEVELOPMENT • DEVELOPMENTAL ANOMALIES • THE SURFACTANT SYSTEM • RESPIRATORY DISTRESS SYNDROME • MECONIUM ASPIRATION SYNDROME • PERSISTENT PULMONARY HYPERTENSION OF THE NEWBORN • AIR LEAKS • REFERENCES Chapter 30 - Bronchopulmonary Dysplasia • DEFINITION AND INCIDENCE • PATHOGENESIS • PATHOPHYSIOLOGIC CHANGES • MANAGEMENT • OUTCOME • PREVENTION STRATEGIES • REFERENCES Chapter 31 - Principles of Management of Respiratory Problems • OXYGEN THERAPY • ASSESSMENT OF GAS EXCHANGE • STRATEGIES FOR RESPIRATORY SUPPORT • MANAGEMENT IN THE INTENSIVE CARE SETTING • REFERENCES Chapter 32 - Extracorporeal Membrane Oxygenation • INDICATIONS • PROCEDURE • EQUIPMENT AND SYSTEMS • PATIENT MANAGEMENT • SUMMARY • REFERENCES Chapter 33 - Cardiac Disease • Incidence • Infant Mortality • Long-Term Survival • Etiology • Fetal Cardiology • Fetal Cardiac Intervention • Prematurity • Recognition of Clinical Features • Diagnostic Tools • Diagnostic Cardiac Catheterization and Angiography • Management Procedures for Severe Cardiac Disease • Cyanotic Lesions • Acyanotic Lesions • Acyanotic Anomalies with Abnormal Cardiac Function or Structure • Arrhythmias • Sinus Arrhythmia • Accelerated Ventricular Rhythm • Junctional Ectopic Tachycardia • Atrioventricular Block • Second-Degree Atrioventricular Block • REFERENCES Chapter 34 - Preoperative and Postoperative Care of the Infant with Critical Congenital Heart Disease • INTRODUCTION • PREOPERATIVE CARE • PREOPERATIVE PHYSIOLOGY AND MANAGEMENT: SPECIFIC LESIONS • POSTOPERATIVE CARE • CONCLUSION • REFERENCES Chapter 35 - Jaundice • Introduction • Formation, Structure, and Properties of Bilirubin • Fetal Bilirubin Metabolism • Neonatal Bilirubin Metabolism • Physiologic Mechanisms of Neonatal Jaundice • Physiologic Jaundice • Bilirubin Toxicity • Clinical Features of Bilirubin Encephalopathy • Clinical Sequelae of Hyperbilirubinemia • The Clinical Approach to the Jaundiced Newborn • Jaundice in the Healthy Newborn • Pathologic Causes of Jaundice • Newer Developments that Affect Our Approach to the Jaundiced Newborn • Prevention, Identification, and Management of Neonatal Hyperbilirubinemia • Laboratory Measurements of Bilirubin • Preventing Extreme Hyperbilirubinemia and Kernicterus • Treatment • Phototherapy • Exchange Transfusion • Pharmacologic Treatment • Physiologic Role of Bilirubin • Acknowledgment • REFERENCES Chapter 36 - Calcium and Magnesium Homeostasis • TISSUE DISTRIBUTION • CIRCULATING CONCENTRATION • PHYSIOLOGIC CONTROL • NONCLASSIC CONTROL OF CALCIUM AND MAGNESIUM HOMEOSTASIS • DISTURBANCES IN SERUM MINERAL CONCENTRATIONS • SKELETAL MANIFESTATIONS OF DISTURBED MINERAL HOMEOSTASIS • REFERENCES Chapter 37 - Carbohydrate Homeostasis • MATERNAL METABOLISM DURING PREGNANCY • DEVELOPMENT OFGLUCOSE-PRODUCING AND GLUCOREGULATORYCAPABILITIES IN THE FETUS • NEONATAL GLUCOSE REQUIREMENTS • DIAGNOSIS AND TREATMENT • CONSEQUENCES • REFERENCES Chapter 38 - Congenital Anomalies • DEFINITIONS AND CLASSIFICATIONS • MANAGEMENT STRATEGY • SELECTED EXAMPLES • GENETIC COUNSELING • REFERENCES Chapter 39 - Endocrine Disorders of the Newborn • DISORDERS OF SEXUAL DIFFERENTIATION • DISORDERS OF CHROMOSOMAL SEX • DISORDERS OF GONADAL DETERMINATION • DISORDERS OF PHENOTYPIC SEX • OTHER CONDITIONS INVOLVING GENITOURINARY DEVELOPMENT • EVALUATION • DISORDERS OF THE HYPOTHALAMUS AND PITUITARY • DISORDERS OF THE ANTERIOR PITUITARY • DISORDERS OF THE POSTERIOR PITUITARY • DISORDERS OF THE ADRENAL GLAND • ADRENAL INSUFFICIENCY • DISORDERS OF THE THYROID • THYROID FUNCTION TESTS • RESISTANCE TO THYROID HORMONES • UNRESPONSIVENESS TO THYROID-STIMULATING HORMONE • SECONDARY AND TERTIARY HYPOTHYROIDISM • SYMPTOMS OF HYPOTHYROIDISM • DIAGNOSIS • TREATMENT AND PROGNOSIS • EUTHYROID SICK SYNDROME • CONSUMPTIVE HYPOTHYROIDISM SECONDARY TO GIANT HEMANGIOMA • CONGENITAL THYROTOXICOSIS • REFERENCES Chapter 40 - Gastrointestinal Disease • DEVELOPMENT OF THE GASTROINTESTINAL TRACT • GASTROINTESTINAL HORMONES AND ENTERIC NEUROPEPTIDES • ABNORMALITIES OF THE GASTROINTESTINAL TRACT • REFERENCES Chapter 41 - Inherited Metabolic Disorders • CLINICAL MANIFESTATIONS OF INBORN ERRORS OF METABOLISM • HYPERAMMONEMIA • METABOLIC ACIDOSIS • EMERGENCY TREATMENT OF THE INFANT WITH AN ACUTE METABOLIC ENCEPHALOPATHY • HYPOGLYCEMIA • JAUNDICE AND LIVER DYSFUNCTION • FINDINGS SUGGESTIVE OF A STORAGE DISEASE • ABNORMAL ODOR • DYSMORPHIC FEATURES • ABNORMAL EYE FINDINGS • SAMPLES TO OBTAIN FROM A DYING CHILD WITH A SUSPECTED INBORN ERROR OF METABOLISM • NEWBORN SCREENING FOR INHERITED METABOLIC DISORDERS • MATERNAL METABOLIC DISORDERS • REFERENCES Chapter 42 - Renal Disease • Developmental Physiology • Clinical Evaluation of Renalfunction and Disease • Physical Examination • Acute Renal Failure and Oligoanuria • Nephrotoxicity • Nonsteroidal Antiinflammatory Agents • Management of CKD in Infancy • Summary • Hypertension • Bacteriuria and Urinary Tract Infections • Tubular Dysfunction • Congenital Nephrotic Syndrome • REFERENCES Chapter 43 - Structural Abnormalities of the Genitourinary Tract • IMAGING • ANOMALIES OF THE KIDNEY • ANOMALIES OF THE URETERS AND BLADDER • GENITAL ABNORMALITIES • URINARY TRACT INFECTION • UROLOGIC ASPECTS OF MYELODYSPLASIA • PRUNE-BELLY SYNDROME • UROLOGIC IMPLICATIONS OF IMPERFORATE ANUS • FEMALE GENITAL ABNORMALITIES • ACKNOWLEDGMENT • REFERENCES Chapter 44 - Surgical Care of Conditions Presenting in the Newborn • LESIONS OF THE HEAD AND NECK • MASSES IN THE NECK • UPPER AIRWAY OBSTRUCTION CAUSING RESPIRATORY DISTRESS • THORACIC LESIONS CAUSING RESPIRATORY DISTRESS • LESIONS OF THE ESOPHAGUS • ABDOMINAL SURGERY • DISORDERS OF THE GENITALIA • OBSTRUCTIVE JAUNDICE • HERNIA AND HYDROCELE • ABNORMALITIES OF THE UMBILICUSAND ABDOMINAL WALL • UMBILICAL GRANULOMA • SACROCOCCYGEAL TERATOMA • VASCULAR ACCESS • REFERENCES Chapter 45 - Immunology of the Fetus and Newborn • DEVELOPMENT OF THE IMMUNE SYSTEM • INFLAMMATORY RESPONSE • CELLULAR COMPONENTS • POLYMORPHONUCLEAR • PHAGOCYTOSIS • MONOCYTES AND MACROPHAGES • HUMORAL COMPONENT • FIBRONECTIN ANDADHESION MOLECULES • CYTOKINES • ANTIBODIES • OPSONIC CAPACITY • ADAPTIVE IMMUNE MECHANISMS • HEMATOPOIETIC DIFFERENTIATION • LYMPHOPOIETIC DIFFERENTIATION • T-CELL SYSTEM • T CELLS • B-CELL SYSTEM • MATERNAL, FETAL, AND NEONATAL INTERACTIONS • IMMUNOLOGIC CONSEQUENCES OF INTRAUTERINE INFECTIONS • IMMUNOLOGIC EVALUATION • NEONATAL IMMUNE RESPONSE TO HUMAN IMMUNODEFICIENCY VIRUS • EVALUATION OF THE HUMORAL IMMUNE SYSTEM • EVALUATION OF THE CELL-MEDIATED IMMUNE SYSTEM • IMMUNOLOGIC THERAPY • PREVENTION OF INFECTION IN LOW BIRTH WEIGHT INFANTS • TREATMENT OF PRESUMED NEONATAL INFECTION • GROUP B STREPTOCOCCAL INFECTION • SPECIFIC ANTIBODY REPLACEMENT THERAPY • SUMMARY OF RECENT CONSIDERATIONS CONCERNING THE USE OF INTRAVENOUS IMMUNOGLOBULIN IN NEONATAL SEPSIS • ACTIVE IMMUNIZATION OF PREGNANT WOMEN • USE OF RECOMBINANT HUMAN GRANULOCYTE-COLONY STIMULATING FACTOR OR GRANULOCYTE-MACROPHAGE COLONY-STIMULATING FACTOR • PLASMA COMPONENT TRANSFUSION • PNEUTROPHIL TRANSFUSION THERAPY • REFERENCES Chapter 46 - Hematology • Anemias • Bleeding Disorders • Platelet Disorders • Leukocytes • Transfusion of Blood and Blood Products • Thrombosis and Embolism • Acknowledgments • REFERENCES Chapter 47 - Bacterial and Fungal Infections • EPIDEMIOLOGY • PHARMACOLOGIC BASIS OF ANTIMICROBIAL THERAPY • SEPSIS NEONATORUM • SYPHILIS • BACTERIAL MENINGITIS • OSTEOMYELITIS AND SEPTIC ARTHRITIS • CUTANEOUS INFECTIONS • URINARY TRACT INFECTION • NEONATAL OPHTHALMIA • DIARRHEAL DISEASE • LOWER RESPIRATORY TRACT INFECTION • OTITIS MEDIA • PERITONITIS • REFERENCES Chapter 48 - Viral and Protozoal Infections • Introduction • Rubella • Herpes Simplex Virus Infections • Cytomegalovirus Infections • Varicella • Other Herpesvirus Infections • Parvovirus B19 Infections • Hepatitis Virus Infections • Lymphocytic Choriomeningitis Virus • West Nile Virus • Human Immunodeficiency Virus Type 1 Infection • Toxoplasmosis • Miscellaneous Viral and Protozoal Pathogens • REFERENCES Chapter 49 - Healthcare-Associated Infections • EPIDEMIOLOGY • HEALTHCARE-ASSOCIATED INFECTION RATE • LATE-ONSET SEPSIS • VENTILATOR-ASSOCIATED PNEUMONIA • URINARY TRACT INFECTIONS • INFECTIONS DUE TO MULTI-DRUG RESISTANT ORGANISMS • VIRAL INFECTIONS • INFECTION CONTROL MEASURES • REFERENCES Chapter 50 - Neurological and Neuromuscular Disorders • NEUROLOGIC EVALUATION OF THE NEWBORN • NEONATAL SEIZURES • HYPOXIC-ISCHEMIC CEREBRAL INJURY • MAJOR NEUROPATHOLOGIC PATTERNS OF INJURY • INTRACRANIAL HEMORRHAGE • SUBDURAL HEMORRHAGE • PRIMARYSUBARACHNOID HEMORRHAGE • INTRACEREBELLAR HEMORRHAGE • INTRAVENTRICULAR HEMORRHAGE IN THE TERM NEWBORN • BRAIN DEATH IN NEONATES • NEUROMUSCULAR DISORDERS • PERIPHERAL NERVE DISORDERS • DISORDERS OF THENEUROMUSCULAR JUNCTION • REFERENCES Chapter 51 - Neurosurgery of the Newborn • THE PATHOPHYSIOLOGY OF NEONATAL NEUROSURGERY • FLUID COLLECTIONS AND THEIR MANAGEMENT • MANAGEMENT OF THE INFANT WITH AN OPEN DEFECT OF THE NEURAL AXIS • REMOVAL OF EXCESS INTRACRANIAL MASS • OPENING PREMATURE FUSIONS IN THE NEONATE • CEREBROVASCULAR ANOMALIES OF THE NEWBORN • PROGNOSIS AND LONG-TERM OUTLOOK FOR THE NEUROSURGICAL NEONATE • REFERENCES Chapter 52 - Orthopedics • PHYSICAL EXAMINATION • MUSCULOSKELETAL ANOMALIES • GENERALIZED MUSCULOSKELETAL ANOMALIES • BIRTH FRACTURES • OBSTETRIC PALSY • BONE AND JOINT INFECTIONS • REFERENCES Chapter 53 - Neoplasia • EPIDEMIOLOGY • DEVELOPMENTAL GROWTH DISTURBANCES, GENETIC ABERRATIONS, AND CANCER PATHOGENESIS • EXPOSURE TO MATERNAL MALIGNANCY • PRENATAL EXPOSURE TO MATERNAL GENOTOXINS • TUMORS OF NEUROEPITHELIAL ORIGIN • CONGENITAL LEUKEMIA • NEOPLASMS OF THE KIDNEY • TUMORS OF GERM CELL ORIGIN • ENDODERMAL SINUS OR YOLK SAC TUMORS • PRIMARY HEPATIC NEOPLASMS • SOFT TISSUE SARCOMAS • VASCULAR NEOPLASMS AND MALFORMATIONS • HISTIOCYTOSES • THERAPEUTIC ISSUES AND LATE EFFECTS OF THERAPY • REFERENCES Chapter 54 - Eye Disorders • GENERAL CONSIDERATIONS • EXAMINATION TECHNIQUES • CONGENITAL ANOMALIES • ACQUIRED DISORDERS • TRAUMA • PHOTOTHERAPY FOR HYPERBILIRUBINEMIA • RETINOPATHY OF PREMATURITY • COMMON DIFFERENTIALDIAGNOSTIC PROBLEMS • REFERENCES Chapter 55 - Dermatologic Conditions • INTRODUCTION • SKIN DEVELOPMENT, STRUCTURE, AND FUNCTION • EXAMINATION OF NEWBORN SKIN • SCALY RASHES • VESICLES AND PUSTULES • DISORDERS OF PIGMENTATION (BROWN SPOTS/WHITE SPOTS) • BROWN SPOTS • ATROPHIC LESIONS • TRANSIENT VASCULAR LESIONS • VASCULAR GROWTHS • CYSTS AND NODULES • EDEMA • PURPURA • YELLOW-ORANGE LESIONS • REFERENCES Part VI - Pharmacology Chapter 56 - Drug Therapy in the Newborn • PRINCIPLES OF PHARMACOLOGY APPLIED TO NEONATES • PHARMACOKINETICS • CLINICAL TOXICOLOGY • SPECIFIC CLASSES OF DRUGS • DRUG EXCRETION IN BREAST MILK • REFERENCES Chapter 57 - Anesthesia and Analgesia in the Neonate • PAIN PERCEPTION • ANESTHESIA • ANALGESIA • NONPHARMACOLOGIC TECHNIQUES • SEDATION • CLONIDINE • SUMMARY • REFERENCES Chapter 58 - The Infant of the Drug-Dependent Mother • EPIDEMIOLOGY • NARCOTICS • HISTORY • ANTENATAL PROBLEMS • NEONATAL PROBLEMS • NONNARCOTIC HYPNOSEDATIVES • BARBITURATES • CHLORDIAZEPOXIDE AND DIAZEPAM • OTHER HYPNOSEDATIVES • DIFFERENTIAL DIAGNOSIS • COCAINE • ALCOHOL • MARIJUANA • NICOTINE AND SMOKING • PHENCYCLIDINE • AMPHETAMINES • CLUB DRUGS (ECSTASY, GHB, KETAMINE) • CAFFEINE • DIAGNOSIS OF DRUG EXPOSURE • TREATMENT • DRUG-ADDICTED WOMEN AS INFANT CAREGIVERS • FOLLOW-UP • REFERENCES Part VII - Beyond the Nursery Chapter 59 - Medical Care After Discharge • EXPECTATIONS OF GROWTH • FEEDING PROBLEMS • IMMUNIZATIONS • SPECIALIZED CARE • DISCHARGE PLANNING • REFERENCES Chapter 60 - Developmental Outcome • ORGANIZATION OF A HIGH-RISK INFANT FOLLOW-UP PROGRAM • NEURODEVELOPMENTAL OUTCOME OF LOW-BIRTH-WEIGHT PREMATURE INFANTS • SPECIFIC PERINATAL-NEONATAL COMPLICATIONS IN HIGH-RISK INFANTS • REFERENCES Appendices • Appendix A: The Healthcare Matrix • Appendix B: Hemoglobin–Oxygen Dissociation Curves • Appendix C: Breast Milk in the NICU • Appendix D: Growth Parameters • Appendix E: Jaundice • Appendix F: Blood Pressure • Appendix G: Renal and Urinary Tract Anomalies • Appendix H: Drug Formulary • Appendix I: Nutrients Values • Appendix J: Technical Procedures • Color Plate Index Chapter 1 Neonatology: Past, Present and Future Gordon B.

Critics may validly argue that American medicine and public policy have neglected primary prevention and fostered the technological imperative. To counter these criticisms, the moral priorities of NPM specialists need to include advocacy for comprehensive prenatal care, improved nutrition, prevention of premature delivery and appropriate family support and services for the infant after discharge. NPM in the United States is also part of a global community of science, medicine, and humanitarian outreach.

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